2017 MEDICARE SAVINGS PROGRAM (MSP) ALLOWABLE INCOME SINGLE BENEFIT MARRIED MONTHLY INCOME MONTHLY INCOME (OR MARRIED LIVING APART) 1374.00 1025.00 QMB 1644.00 1226.00 SLMB 1377.00 1847.00 QI-1 5499.00 4105.00 QDWI ALLOWABLE RESOURCES: THERE IS NO RESOURCE LIMIT IN ALABAMA
2017 LOW INCOME SUBSIDY (EXTRA HELP) ALLOWABLE RESOURCES FU LL SUBSIDY (100 - 135%) Single $ 8,890 $14,090 Married
PARTIAL SUBSIDY (140 - 150%) $13,820 Single $27,600 Married
ALLOWABLE INCOME FAMILY SIZE 1 2 3 4 5 6 7 8 Each Additional Person
PERCENT OF POVERTY GUIDELINE 100% 1025.00 1373.33 1721.66 2069.99 2418.32 2766.65 3114.98 3463.31
135% 1376.75 1847.00 2317.25 2787.50 3257.75 3728.00 4198.25 4668.50
1400/o 1427.00 1914.66 2402.32 2889.98 3377.64 3865.30 4352.96 4840.62
145% 1477.25 1982.33 2487.41 2992.49 3497.57 4002.65 4507.73 5012.81
150% 1527.50 2050.00 2572.50 3095.00 3617.50 4140.00 4662.50 5185.00
+348.33
+470.25
+487.66
+505.08
+522.50
2017 Maximum LISBeneficiary Cost-Sharing Table
Low-income Subsidy Category
Copayment up to Out-of-Pocket
Copayment above Out-of-pocket
Deductible
Threshold*
Threshold*
$0
$0
$0
$0
$1.20 generic, $3.70 brand $3.30 generic, $8.25 brand
$0
lnstitutionatized Full-Benefit Dual Eligible; or Beneficiaries Receiving Home and CommunityBased Services Full-Benefit Dual Eligible
100% FPL
Full-Benefit Dual Eligible > 100% FPL; or
$0
Medicare Saving Program Participant (QMB-only, SLMB-only, or QI); or
$0
Supplemental Security Income (but not Medicaid) Recipient; or Applicant < 135% FPL with resources at or <$8,890 ($14,090 if married)** Applicant < 150% FPL with resources between 15% $82 $8,890 - $13,820 ($14,090 - $27,600 if married)** *Out-of-Pocket Threshold is $4,950 for 2017. ** Resource limits displayed include $1,500 per person for burial expenses.
3
$3.30 generic, $8.25 brand